Verification of Hillcrest Baptist Medical Centers Refund of Place-of-Service Overpayments for Calendar Years 2007 through 2009.
(12/04/2013)
Physicians are required to identify the place of service on the health insurance claim forms that they submit to Medicare contractors. The correct place-of-service code ensures that Medicare does not reimburse a physician incorrectly for the overhead portion of the payment if the service was performed in a facility setting. Our previous nationwide reviews found that several contractors overpaid physicians who did not correctly identify the place of service on their claims. These audits identified over a million nonfacility-coded physician services that matched outpatient hospital claims for the same type of service provided to the same beneficiary on the same...
Tác giả: NTIS |
Số trang: 16 |
Lĩnh vực: Y học lâm sàng |
Năm XB: 2011 |
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Verification of Hillcrest Baptist Medical Centers Refund of Place-of-Service Overpayments for Calendar Years 2007 through 2009. | Số trang: 16
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Physicians are required to identify the place of service on the health insurance claim forms that they submit to Medicare contractors. The correct place-of-service code ensures that Medicare does not reimburse a physician incorrectly for the overhead portion of the payment if the service was performed in a facility setting. Our previous nationwide reviews found that several contractors overpaid physicians who did not correctly identify the place of service on their claims. These audits identified over a million nonfacility-coded physician services that matched outpatient hospital claims for the same type of service provided to the same beneficiary on the same day. These reviews identified numerous instances of overpayments to Hillcrest Medical Center (the Hospital) physicians because claims the Hospital submitted contained an incorrect place-of-service code. The Hospital submits claims for the overhead expenses of medical services performed at the Hospital and bills on behalf of its physicians for Part B physician services. The Hospital's officials insisted on refunding all overpayments received resulting from these place-of-service coding errors. The Hospital asked the Office of Inspector General to verify the accuracy of its overpayment calculations so it could refund its Medicare contractor. Our objective was to determine the amount of overpayments for claims with place-of-service coding errors submitted by the Hospital to its Medicare contractor for CYs 2007 through 2009.
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